FILE - This 1978 file photo originally released by ABC shows actor Robin Williams on the set of ABCs "Mork and Mindy." Williams, whose free-form comedy and adept impressions dazzled audiences for decades, has died in an apparent suicide. He was 63. The Marin County Sheriff's Office said Williams was pronounced dead at his home in California on Monday, Aug. 11, 2014. The sheriff's office said a preliminary investigation showed the cause of death to be a suicide due to asphyxia. (AP Photo/ABC, File)

Photo: Associated Press

FILE - This 1978 file photo originally released by ABC shows actor...

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Danvers Fletcher, 63, of Hawaii, writes a note to Robin Williams before delivering a bouquet of flowers to a temporary shrine for him August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday.

Photo: Leah Millis, The Chronicle

Danvers Fletcher, 63, of Hawaii, writes a note to Robin Williams...

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David Rabb, 45, picks up a candle to light it in front of a temporary shrine for the late Robin Williams August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday.

Photo: Leah Millis, The Chronicle

David Rabb, 45, picks up a candle to light it in front of a...

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Flowers, notes and photographs line the steps of a temporary shrine for Robin Williams August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday.

Photo: Leah Millis, The Chronicle

Flowers, notes and photographs line the steps of a temporary shrine...

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Chris Villanueva, 24, lights candles at a temporary shrine that has come into existence in the past 24 hours since the news of Robin Williams' death has spread August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday. "He was able to give the bay area some pride." Villanueva said.

Robin Williams is shown in a scene from Fox Searchlight Pictures' new release "One Hour Photo,'' a grim story in which he plays a joyless photo clerk who dangerously fixates on a family. (AP Photo/Fox Searchlight, Francois Duhamel) ALSO RAN 02/21/03

Robin Williams, left, and Matt Damon appear in a scene from the movie "Good Will Hunting" in 1997.

Photo: George Kraychyk, AP

Robin Williams, left, and Matt Damon appear in a scene from the...

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Actor Robin Williams holds up his Oscar after winning in the Best Actor in a Supporting Role category during the 70th Academy Awards 23 March at the Shrine Auditorium in Los Angeles. Williams won for his role as a psychotherapist helping a troubled math genius in "Good Will Hunting."

Photo: Timothy A. Clary, AFP/Getty Images

Actor Robin Williams holds up his Oscar after winning in the Best...

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Robin Williams in "Mrs. Doubtfire" in 1993.

Photo: Phil Bray, 20th Century Fox

Robin Williams in "Mrs. Doubtfire" in 1993.

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This is the first appearance of the alien Mork from Ork (Robin Wiliams, center), which earned him and Williams his own spin-off series, "Mork & Mindy". Mork came to Earth looking for someone to study and picked Richie (Ron Howard, right). Henry Winkler (Fonzie) also starred.

Photo: ABC PHOTO ARCHIVES, Getty Images

This is the first appearance of the alien Mork from Ork (Robin...

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The character of Mork, an alien from the planet of Ork, became so popular from an episode of "Happy Days" that it was spun-off into this series starring Robin Williams in the lead role (his first major acting break). The misfit alien was sent to study Earthlings by his fellow Orkans. Landing in a giant eggshell, near Boulder, Colorado, he was befriended by Mindy McConnell (Pam Dawber), who helped him adjust to Earth's strange ways.

Photo: JIM BRITT, Getty Images

The character of Mork, an alien from the planet of Ork, became so...

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Robin Williams, September 28, 1981. Williams was found dead at his home in Marin County on Monday, Aug. 11, 2014. He was 63.

Photo: Steve Ringman, The Chronicle

Robin Williams, September 28, 1981. Williams was found dead at his...

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Comedian Robin Williams, who will star in "The World According to Garp," is shown, July 21, 1982, in Los Angeles. (AP Photo)

Photo: Anonymous, Wire Photo

Comedian Robin Williams, who will star in "The World According to...

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Robin Williams and Wife Valerie Williams during Robin Williams After "Saturday Night Live" Taping in New York City - November 11, 1978 at NBC Studios in New York City, New York, United States.

Photo: Ron Galella, Getty Images

Robin Williams and Wife Valerie Williams during Robin Williams...

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Robin Williams on Chronicle Comedy Day - July 25, 1987 at the Polo Field in Golden Gate Park. Williams was found dead at his home in Marin County on Monday, Aug. 11, 2014. He was 63.

Photo: Deanne Fitzmaurice, The Chronicle

Robin Williams on Chronicle Comedy Day - July 25, 1987 at the Polo...

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Robin Williams was an aspiring comedian in 1978. Williams was found dead at his home in Marin County on Monday, Aug. 11, 2014. He was 63.

Photo: Ho

Robin Williams was an aspiring comedian in 1978. Williams was...

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Robin Williams at Gary Hart Fundraiser. St. Francis Hotel. Jun 4, 1984. Williams was found dead at his home in Marin County on Monday, Aug. 11, 2014. He was 63.

Photo: Chris Stewart, The Chronicle

Robin Williams at Gary Hart Fundraiser. St. Francis Hotel. Jun 4,...

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Robin Williams, at the age of 7, with his mother Laurie Williams.

Robin Williams, at the age of 7, with his mother Laurie Williams.

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Robin Williams, September 25, 1984.

Photo: Frederic Larson, The Chronicle

Robin Williams, September 25, 1984.

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Robin Williams with Will Durst (left) at Durst's campaign headquarters, after Durst lost a run for mayor. Dec. 9, 1987

Photo: Chronicle Archives

Robin Williams with Will Durst (left) at Durst's campaign...

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Robin Williams, October 4, 1980

Photo: Mike Maloney, The Chronicle

Robin Williams, October 4, 1980

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Robin Williams narrates Peter and the Wolf with a youth symphony on Dec. 12, 1993.

Photo: Brant Ward, The Chronicle

Robin Williams narrates Peter and the Wolf with a youth symphony on...

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Robin Williams in the 1980s.

Photo: Frederic Larson, The Chronicle

Robin Williams in the 1980s.

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Robin Williams is seen in a November, 1995 file photo.

Photo: Chris Stewart, SFC

Robin Williams is seen in a November, 1995 file photo.

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Jack Nicholson, right, and Robin Williams share a laugh as they pose with their Oscars at the 70th annual Academy Awards at the Shrine Auditorium in Los Angeles, Monday, March 23, 1998. Nicholson won for his role in "As Good As It Gets" and Williams for his role in "Good Will Hunting."

Photo: Reed Saxon, Associated Press

Jack Nicholson, right, and Robin Williams share a laugh as they...

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Holding their Oscar awards for acting, (L to R) Kim Basinger, Robin Williams, Helen Hunt and Jack Nicholson celebrate their success following the 70th Annual Academy Awards, March 23 in Los Angeles. Basinger won best supporting actress for her role in "L.A. Confidential," Williams won best supporting actor for "Good Will Hunting," Hunt won best actress for her role in "As Good As It Gets," and Nicholson won best actor for his role in "As Good As It Gets."

Listening to a few speeches just before the start of the race, from left, Dylan Casey, retired olympian, actor Robin Williams, and George Hincapie, professional bike racer.
A 25-mile Breakaway from Cancer charity bike ride which started at the Marina Green on Dec. 3, 2006.

Photo: Penni Gladstone, SFC

Listening to a few speeches just before the start of the race, from...

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Robin Williams as comedian-turned-candidate Tom Dobbs in "Man of the Year," 2006.

Photo: Photo Credit: Ava Gerlitz / Univ

Robin Williams as comedian-turned-candidate Tom Dobbs in "Man of...

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Awards recipients, director Spike Lee (L) and actor Robin Williams, laugh before the 50th San Francisco International Film Festival's Film Society Awards in San Francisco, California, May 3, 2007.

Comedian and actor Robin Williams appears on MTV's Total Request Live, Thursday, April 27, 2006 at MTV studios in New York City. Williams was found dead at his home in Marin County on Monday, Aug. 11, 2014. He was 63.

Photo: Stephen Chernin, AP

Comedian and actor Robin Williams appears on MTV's Total Request...

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Comedians Robin Williams and Billy Crystal were in the Giants dugout before a game in 2007.

Comedians Robin Williams (left) and Mort Sahl (right) attend opening the opening night party of the Mill Valley Film Festival at the Outdoor Art Club in Mill Valley, California, on Thursday, October 6, 2011.

Photo: Liz Hafalia, The Chronicle

Comedians Robin Williams (left) and Mort Sahl (right) attend...

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Robin Williams helped out Google's Larry Page with explaining some of the computer terms at the Consumer Electronics Show in Las Vegas.

Photo: Kurt Rogers, SFC

Robin Williams helped out Google's Larry Page with explaining some...

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Sean Penn (left) with actor Robin Williams and comedian Frank Ferrante at Teatro ZinZanni for a fundraiser in 2010.

Photo: Catherine Bigelow, Special To The Chronicle

Sean Penn (left) with actor Robin Williams and comedian Frank...

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The San Francisco Film Society hosted its 50th Awards Gala at the St. Francis Hotel with Robin Williams in 2010.

Photo: Pamela Gentile, Freelance

The San Francisco Film Society hosted its 50th Awards Gala at the...

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The San Francisco Film Society hosted its 50th Awards Gala at the St. Francis Hotel in 2010.
From left: Comedian Bonnie Hunt presented the Film Award to Robin Williams.

Photo: Drew Altizer, Freelance

The San Francisco Film Society hosted its 50th Awards Gala at the...

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In this file photo from Thursday, Oct. 7, 2010, actor Robin Williams hugs San Francisco Giants mascot Lou Seal during the first inning of Game 1 of baseball's National League Division Series in San Francisco.

Photo: Ben Margot, Wire Photo

In this file photo from Thursday, Oct. 7, 2010, actor Robin...

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Robin Williams and Tony Bennett pose backstage at the hit play "Bengal Tiger At The Baghdad Zoo" on Broadway at The Richard Rogers Theater on May 4, 2011 in New York City.

Photo: Bruce Glikas, Getty Images

Robin Williams and Tony Bennett pose backstage at the hit play...

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Robin Williams, with his daughter, Zelda Williams, right, and third wife Susan Schneider arrive at the premiere of "Happy Feet Two" at Grauman's Chinese Theater in 2011.

Photo: Katy Winn, Wire Photo

Robin Williams, with his daughter, Zelda Williams, right, and third...

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Onlookers mill around and photograph a temporary shrine for the late Robin Williams August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday.

Photo: Leah Millis, The Chronicle

Onlookers mill around and photograph a temporary shrine for the...

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ABC's Cecilia Vega prepares for a live shot outside of a temporary shrine for the late Robin Williams August 12, 2014 at the home where "Mrs. Doubtfire" was filmed in San Francisco, Calif. Williams was found dead in his home on Monday.

Photo: Leah Millis, The Chronicle

ABC's Cecilia Vega prepares for a live shot outside of a temporary...

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Caitlin Kerton adjusts her flowers after taking a picture with friend Samantha McMullen outside the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

Caitlin Kerton adjusts her flowers after taking a picture with...

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People stand outside the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

People stand outside the Mrs. Doubtfire house on August 11, 2014 in...

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A woman lays flowers and a card on the steps of the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

A woman lays flowers and a card on the steps of the Mrs. Doubtfire...

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Jordan Ansell pays respects to comedian and actor Robin Williams outside the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

Jordan Ansell pays respects to comedian and actor Robin Williams...

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Outside the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

Outside the Mrs. Doubtfire house on August 11, 2014 in San...

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A heart-shaped note and several bouquets of flowers lay in front of the home of Robin Williams in Tiburon, Calif. on Monday, August 11, 2014.

Photo: Scott Strazzante, The Chronicle

A heart-shaped note and several bouquets of flowers lay in front of...

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Debbie Maina from Jacksonville, Florida, leaves a bouquet of flowers at Robin Williams' former home in the Sea Cliff neighborhood in San Francisco, Calif., on Monday, August 11, 2014. Williams was found dead in his Tiburon home earlier in the day and fans and friends left flowers and notes to honor the comedy and acting legend.

Photo: Carlos Avila Gonzalez, The Chronicle

Debbie Maina from Jacksonville, Florida, leaves a bouquet of...

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People pay respects to comedian and actor Robin Williams outside the Mrs. Doubtfire house on August 11, 2014 in San Francisco, CA. Robin Williams was found dead this morning in his Tiburon home.

Photo: Craig Hudson, The Chronicle

People pay respects to comedian and actor Robin Williams outside...

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A flower lays in the street in front of Robin Williams' home in Tiburon, Calif. on Monday, August 11, 2014.

Photo: Scott Strazzante, The Chronicle

A flower lays in the street in front of Robin Williams' home in...

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L-R, Brian Duncan, Alexis Cooney, and Nick Cooney, embrace after bringing flowers to Robin Williams' former home in the Sea Cliff neighborhood in San Francisco, Calif., on Monday, August 11, 2014. Williams was found dead in his Tiburon home earlier in the day and fans and friends left flowers and notes to honor the comedy and acting legend.

Photo: Carlos Avila Gonzalez, The Chronicle

L-R, Brian Duncan, Alexis Cooney, and Nick Cooney, embrace after...

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A small bouquet of flowers and note were placed at the front gate at Robin Williams' former home in the Sea Cliff neighborhood in San Francisco, Calif., on Monday, August 11, 2014. Williams was found dead in his Tiburon home earlier in the day and fans and friends left flowers and notes to honor the comedy and acting legend.

Photo: Carlos Avila Gonzalez, The Chronicle

A small bouquet of flowers and note were placed at the front gate...

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A woman, who did not want to be identified, stands with her pet dog in front of the home of Robin Williams in Tiburon, Calif. on Monday, August 11, 2014.

Photo: Scott Strazzante, The Chronicle

A woman, who did not want to be identified, stands with her pet dog...

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After hearing about Robin Williams' death, Lou Sterling, a neighbor who used to bike with Williams, reacts near Williams' home in Tiburon, Calif. on Monday, August 11, 2014.

Photo: Scott Strazzante, The Chronicle

After hearing about Robin Williams' death, Lou Sterling, a neighbor...

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Two area residents stand near the home of Robin Williams in Tiburon, Calif. on Monday, August 11, 2014.

Photo: Scott Strazzante, The Chronicle

Two area residents stand near the home of Robin Williams in...

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Robin Williams for a feature on their new movie "World's Greatest Dad."

Actor and comedian Robin Williams' apparent suicide focuses attention on the challenges of treating depression and other psychological disorders, even among those who have access to money and professional help.

Mental health experts expressed concern Tuesday about how Williams' death at 63 in his California home would affect people facing similar struggles. Depression or other types of mood disorders strike one in five American adults during their lifetimes.

"I get concerned about people wondering if people as promising as him with all these resources available can't make it, what are the chances for them?" said Patricia Arean, a UCSF clinical psychologist and psychiatry professor.

Effective medications and other treatments are available, even for the most severe depression, mental health experts said. But the approach to finding which of them works best can be a hit-and-miss, frustrating experience for patients and cause a delay in recovery.

"Unfortunately, what happens is that people don't know enough about their own illness to know if they're not getting better," Arean said. If not, they need to move on to a different form of therapy.

While Williams was open about his long-term battle with alcoholism and cocaine addiction, he was less public about his mental health issues or what treatment he sought. His publicist said Monday, the day Williams died, that the comic actor suffered from severe depression.

White men's risk

Health experts say Williams' battle with addiction as a form of self-medication fit with a common profile of someone battling depression, and being a white man older than 60 put him at a higher risk of suicide.

"A white male over 60 with alcohol abuse is our prime candidate for suicide, no matter how famous you are," said Dr. Laura Davies, a psychiatrist who treats people of all ages at California Pacific Medical Center in San Francisco.

While suicides among women start to drop after age 60, that's not true of men. Older white men have the highest rate of suicide of any age and ethnic demographic in the U.S. at about 29 per 100,000 overall.

Davies said treatment for depression is effective, but people have to seek help.

"We can treat it with medicine, we can treat it with therapy," she said. "But we can't treat it if we can't talk about it."

Even so, there's room for improvement in treatments, said Dr. Winston Chung, medical director of inpatient psychiatry at California Pacific Medical Center. He said researchers need to better understand the biology of mental health issues to reduce the stigma and produce more accurate treatments.

Chung said more research and money needs to be put into finding biological markers and genetic traits for mental health problems.

Hidden illness

"With cancer, you can see the cells under the microscope. In depression, you can't see it. There's no broken bone, no radiological finding," he said. "We need to have concrete evidence, not unlike the cancer cell. Something we can see and reliably associate with mental health issues."

Such research could help determine why some people respond better to one medication than another or why some patients are resistant to treatment, said Lea Williams, a Stanford clinical psychologist and psychiatry professor who specializes in depression.

As medical research gets better at determining which cancer tumor will respond better to therapies, the same biological understanding has to happen in mental health, she said. Depression, like other illnesses, isn't about willpower.

"They're all complex diseases," she said. "But, with depression, there's still that idea that it's something you can fix yourself just by trying."

Chung said it may never be clear what kind of emotional problems plagued Williams. But he said someone suspected of having a bipolar disorder may project the manic, on-top-of-the-world energy that Williams displayed as a way of avoiding negativity and pain.

"They say a mature psychological defense is humor," Chung said. "Maybe it's not a mistake that those people with such intense sadness would be able to master humor so well."

Need help?

The National Suicide Prevention/Crisis line is (800) 273-TALK (8255)

Sources: Mental Health Association of San Francisco, Chronicle research